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Co-colonisation with Aspergillus fumigatus and Pseudomonas aeruginosa is associated with poorer health in cystic fibrosis patients: an Irish registry analysis
- Source :
- BMC Pulmonary Medicine, Vol 17, Iss 1, Pp 1-8 (2017), BMC Pulmonary Medicine, Articles
- Publication Year :
- 2017
- Publisher :
- BMC, 2017.
-
Abstract
- Background Pulmonary infection is the main cause of death in cystic fibrosis (CF). Aspergillus fumigatus (AF) and Pseudomonas aeruginosa (PA) are the most prevalent fungal and bacterial pathogens isolated from the CF airway, respectively. Our aim was to determine the effect of different colonisation profiles of AF and PA on the clinical status of patients with CF. Methods A retrospective analysis of data from the Cystic Fibrosis Registry of Ireland from 2013 was performed to determine the effect of intermittent and persistent colonisation with AF or PA or co-colonisation with both microorganisms on clinical outcome measures in patients with CF. Key outcomes measured included forced expiratory volume in one second (FEV1), number of hospitalisations, respiratory exacerbations and antimicrobials prescribed, and complications of CF, including CF related diabetes (CFRD) and allergic bronchopulmonary aspergillosis (ABPA). Results The prevalence of AF and PA colonisation were 11% (5% persistent, 6% intermittent) and 31% (19% persistent, 12% intermittent) in the Irish CF population, respectively. Co-colonisation with both pathogens was associated with a 13.8% reduction in FEV1 (p = 0.016), higher levels of exacerbations (p = 0.042), hospitalisations (p = 0.023) and antimicrobial usage (p = 0.014) compared to non-colonised patients and these clinical outcomes were comparable to those persistently colonised with PA. Intermittent and persistent AF colonisation were not associated with poorer clinical outcomes or ABPA. Patients with persistent PA had a higher prevalence of CFRD diagnosis (p = 0.012). Conclusions CF patients co-colonised with AF and PA had poor clinical outcomes comparable to patients persistently colonised with PA, emphasising the clinical significance of co-colonisation with these microorganisms. Electronic supplementary material The online version of this article (doi:10.1186/s12890-017-0416-4) contains supplementary material, which is available to authorized users.
- Subjects :
- 0301 basic medicine
Male
Cystic Fibrosis
Co-colonisation
medicine.disease_cause
Cystic fibrosis
Pulmonary function testing
Forced Expiratory Volume
Medicine and Health Sciences
Registries
Child
Cause of death
education.field_of_study
Middle Aged
Child, Preschool
Pseudomonas aeruginosa
Aspergillus fumigatus
Pulmonary function
Female
medicine.symptom
Allergic bronchopulmonary aspergillosis
Research Article
Pulmonary and Respiratory Medicine
Adult
medicine.medical_specialty
Adolescent
030106 microbiology
Population
03 medical and health sciences
Young Adult
Age Distribution
Internal medicine
medicine
Humans
Clinical significance
Pseudomonas Infections
education
Aged
Retrospective Studies
lcsh:RC705-779
business.industry
Aspergillosis, Allergic Bronchopulmonary
Sputum
lcsh:Diseases of the respiratory system
Immunoglobulin E
medicine.disease
Surgery
Linear Models
business
Ireland
Subjects
Details
- Language :
- English
- ISSN :
- 14712466
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Pulmonary Medicine
- Accession number :
- edsair.doi.dedup.....65e5b9a87a3ac40f1fca378aa57d41c0